Understanding Female Sex Addiction

Written By: Alexandra Katehakis, MFT CSAT & Caroline Frost, M.A. Date: September 30th, 2010. Topic: Other Addictions.

With all the skepticism about whether sex addiction really exists, it seems people are even more reluctant to accept that women could be capable of being addicted to sex. After all, aren’t women biologically wired to be choosy about their partners? Don’t women suffer, instead, from too little interest in sex? If anything, aren’t women perceived as being too frigid and fickle about getting it on? Nonsense.

Women may be just as vulnerable to sex addiction as men.

Sex addiction is a problem that involves any pattern of uncontrollable sexual behavior that is secretive, shaming, or abusive. Sexual addiction is characterized by the terrible messes the behavior creates — lost jobs, ended relationships, arrest, disease, and death. It is a pernicious disease that flourishes in secrecy. There are some general distinctions between the way sex addiction presents in men and women, however, the etiology behind addictions in both sexes is likely the same: early wounding, traumatic experiences, and negative core beliefs.

Negative core beliefs are the genesis and fuel for acting-out behavior. From these core beliefs come the cognitive distortions that allow addicts to justify and rationalize acting out. According to Patrick Carnes, the sexual addict’s core beliefs are

“I am basically a bad, unworthy person.”
“No one would love me as I am.”
“My needs are never going to get met if I have to depend on others.”
“Sex is my most important need.” (i)

With a commitment to getting help through therapy and the 12-step program, addicts will soon have experiences that counteract those beliefs. For example, by adhering to a sexual sobriety plan, addicts in recovery quickly report that they no longer feel bad or unworthy. Likewise, the 12-step program is a “come as you are” program, so the core belief that they are unlovable quickly diminishes. The third core belief, “My needs are never going to get met if I have to depend on others,” is eradicated by the inherent structure of the program, which involves people reaching out to others, making phone calls for support, and going to fellowship. Many addicts in 12-step programs report that for the first time they have the experience of getting their needs met by others. Finally, through a commitment to a period of planned celibacy, people realize that sex is not their most important need. In fact, they learn that they have other, more important dependency needs, such as comfort, validation, and friendship.

Kelly McDaniel, author of Ready to Heal, has adapted Carnes’ core beliefs to include the confusing cultural messages that are at the heart of women’s addictive and compulsive sexual behavior. These four cultural beliefs are:

I must be good to be worthy of love.
If I am sexual, I am bad.
I am not really a woman unless someone desires me sexually or romantically.
I must be sexual to be lovable.

These beliefs compel a woman to compromise her interests and values in the pursuit of sex and romance, which are the primary ways she knows to get love. She may not know how to communicate her wants and needs to another, or even know what they are in the first place. She may struggle with setting boundaries and find it difficult to say no, constantly taking on responsibilities to the point of exhaustion or resentment. Her compulsive need to be liked makes her avoid confrontation and direct expression of anger. Instead, she might resort to passive aggression as a way to regain some sense of power and to vent her bottled feelings. These patterns fit a term called codependency, which is a partner to addiction and a common struggle for many women. While common, codependent behaviors left unchallenged can devolve into more destructive patterns, especially if a person has suffered abuse or trauma in childhood.

In a study of male and female sexual addicts (Carnes 1991), Patrick Carnes found that addicted women tended toward “behaviors that distort power – either in gaining control over others or being a victim.” Many of these women gravitated toward stripping, prostitution, or sadomasochism. They might engage in relationships where the men were “one-down” or perceived to be beneath them. Or they might have sex with men who degraded or devalued them, reenacting the early trauma of childhood. The men in the study tended to “objectify their partners and require little emotional involvement.” Some examples of objectifying behaviors are anonymous sex, prostitution, pornography, exhibitionism, and frotteurism(ii). In both genders we see addicts inappropriately eroticizing unacknowledged rage. Sexual addicts are often victims of childhood sexual abuse, physical abuse, pathological, or benign neglect. As children they weren’t allowed to express their feelings about being mistreated, neglected, or were in a family where feelings weren’t talked about. Their sexual behavior was a way of self-soothing in the face of unimaginable pain or numbness. As adults they are stuck in the same maladaptive behaviors that, as children, helped them to survive. Because they never learned to voice their outrage, hurt, and sadness, they act out these feelings sexually.

While a cognitive-behavioral, task-centered approach is the standard of care for assisting people to get sexually sober, women and men have different treatment needs. Research shows that females have stronger empathy centers in the brain, are more verbal, and have stronger processing areas for facial expressions and gesture. One study shows that women tend to be empathizers, while men tend to be systemizers. Males and females have both of these capacities, which can be stronger from person to person depending on nature and nurture (Simon Baron-Cohen, 2005). Males tend to analyze the underlying rules of the 12-step program, so they seem to get their treatment underway quickly. They will often intuitively figure out how the system works and are happy to take direction toward the goal or result of their sexual sobriety. Females, however, will leave treatment if they don’t feel attuned to. Females seem to require a higher level of empathy from the therapist, which means that treatment should focus on paying keen attention to her emotions and thoughts and responding appropriately. It may take the female sex addict a while before she is willing to participate in a 12-step program or group therapy.

The old belief that sex addiction is a male problem is outdated, and clinicians need to be able to spot the signs in women and be aware of the different treatment needs of this population. Through effective treatment, a woman begins to feel good about her body, experience sexual pleasure for herself and self-love. A woman is ultimately seeking her personal power, and her capacity to love and be loved. The key to sexual healing for a woman is that she turns toward the pursuit of self-knowledge in order to find her strengths instead of losing herself to others. When a woman begins to integrate her sexuality with self-knowledge and personal power, she reports experiencing the force of love that leads to a whole and complete self.

(i) Patrick J. Carnes

(ii) Carnes, Patrick J. “Gender Differences in Normal and Sexually Addicted Populations”, Am J Preventive Psychiatry & Neurology, 3:1, Spring 1991, pp.16-27

This paper appeared in Phi Kappa Phi Forum 2005 (Special issue on the Human Brain) The Essential Difference: the male and female brain By Simon Baron-Cohen, Cambridge University (page 1)

This article was based on material by the author that first appeared in Gregory, R, (ed) Oxford Companion to the Mind (2nd edition, 2004) Oxford University Press. The author
was supported by the MRC UK during the period of this work.